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Oral Cancers

Determining the Type of Oral Cancer

Only after a pathologist analyzes some cells or actual pieces of tissue from the lesion will your doctor be able to tell you if you have cancer. Your doctor and pathologist should specialize in oral cancers because some benign (non-cancerous) lesions can look like cancer on a small biopsy.

If you actually do have cancer, it will probably be squamous cell carcinoma.

  • Squamous cell carcinoma: This is a cancer that starts from abnormal cells on the surface layer of the lips or mouth lining. More than 85 percent of mouth cancers are squamous cell carcinomas.16, Kademani D. Oral cancer. Mayo Clinic proceedings. Mayo Clinic.Jul 2007;82(7):878-887.17Funk GF, Karnell LH, Robinson RA, Zhen WK, Trask DK, Hoffman HT. Presentation, treatment, and outcome of oral cavity cancer: a National Cancer Data Base report. Head neck. 2002 Feb;24(2):165-80.
  • Carcinoma in situ (also called severe dysplasia): This is really an early stage of squamous cell carcinoma. It is called carcinoma in situ when there are cancerous cells on the tissue lining the oral cavity but they have not invaded past the outermost layer of tissue. These should be removed completely, before they start invading (penetrating more deeply).
  • Verrucous carcinoma: This is a type of squamous cell carcinoma that has a better prognosis because it is less likely to spread. It should be treated as any other squamous cell carcinoma.18Kraus FT, Perezmesa C. Verrucous carcinoma. Clinical and pathologic study of 105 cases involving oral cavity, larynx and genitalia. Cancer. Jan 1966;19(1):26-38. There are a few other subtypes of squamous cell carcinomas as well.

But there are other cancers that can start in the mouth, which include:

  • Salivary gland cancers: There are minor salivary glands located under the lining of the mouth. This is why cancers in this region can be glandular malignancies referred to as adenocarcinomas, including mucoepidermoid carcinomas, and adenoid cystic carcinomas. See Salivary Gland Cancer for more information. In rare instances, salivary gland cancers may grow inside the bone itself.
  • Lymphoma: The mouth also has lymphoid cells under the surface. This is why lymphoma could in rare cases appear as a lump in the mouth.
  • Mucosal melanoma: These cancers come from skin cells (melanocytes) that give skin its color. In rare cases, melanoma can be found in the lining of the mouth, nose and/or throat.
  • Kaposi’s sarcoma: This cancerous tumor is usually associated with AIDS. While it usually presents on the skin, it can be found with a similar appearance in the mouth. It look like a purple lesion in the mouth filled with blood vessels.
  • Osteogenic sarcoma (also called osteosarcoma): This is a type of bone cancer that typically begins in the long bones of the arms and legs, though it can also occur very rarely in the jaw. It is the most common type of bone cancer among children and adolescents.
References

1 Waldron CA,Shafer WG. Cancer.Leukoplakia revisited. A clinicopathologic study 3256oralleukoplakias.1975 Oct;36(4):1386-92.

2 Bombeccari GP, Guzzi G, Tettamanti M, Giannì AB, Baj A, Pallotti F, Spadari F. Oral lichen planus and malignant transformation: a longitudinal cohort study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Sep;112(3):328-34.

3 Mignogna MD, Lo Russo L, Fedele S, Ruoppo E, Califano L, Lo Muzio L. Clinical behaviour of malignant transforming oral lichen planus. Eur J Surg Oncol. 2002 Dec;28(8):838-43.

4 de Vries N, Van der Waal I, Snow GB. Multiple primary tumours in oral cancer. International journal of oral and maxillofacial surgery. Feb 1986;15(1):85-87.

5 Petersen PE, Oral cancer prevention and control – The approach of the World Health Organization, Oral Oncol. 2008.

6 Ko YC, Huang YL, Lee CH, Chen MJ, Lin LM, Tsai CC. Betel quid chewing, cigarette smoking and alcohol consumption related to oral cancer in Taiwan. Journal of oral pathology & medicine: official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology. Nov 1995;24(10):450-453.

7 Ko YC, Huang YL, Lee CH, Chen MJ, Lin LM, Tsai CC. Betel quid chewing, cigarette smoking and alcohol consumption related to oral cancer in Taiwan. Journal of oral pathology & medicine: official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology. Nov 1995;24(10):450-453.

8 SilvermanJr. S. Early diagnosis of oral cancer. Cancer. Oct 15 1988;62(8 Suppl):1796-1799.

9 Scully C, Porter S. ABC of oral health. Oral cancer. BMJ. Jul 8 2000;321(7253):97-100.

10 Neville BW, Day TA. Oral cancer and precancerous lesions. CA: A cancer journal for clinicians. Jul-Aug 2002;52(4):195-215.

11 Spiro RH, Thaler HT, Hicks WF, Kher UA, Huvos AH, Strong EW. The importance of clinical staging of minor salivary gland carcinoma. Am J Surg. 1991 Oct;162(4):330-6.

12 Morton DL, Wen DR, Foshag LJ, Essner R, Cochran A. Intraoperative lymphatic mapping and selective cervical lymphadenectomy for early-stage melanomas of the head and neck. J Clin Oncol. 1993;11:1751-6.

13 Civantos FJ, Zitsch RP, Schuller DE, Agrawal A, Smith RB, Nason R, Petruzelli G, Gourin CG, Wong RJ, Ferris RL, El Naggar A, Ridge JA, Paniello RC, Owzar K, McCall L, Chepeha DB, Yarbrough WG, Myers JN. Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1-T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial. J Clin Oncol. 2010 Mar 10;28(8):1395-400.

14 Koch WM, Choti MA, Civelek AC, Eisele DW, Saunders JR. Gamma probe-directed biopsy of the sentinel node in oral squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 1998. 124:455-9.

15 Shoaib T, Soutar DS, MacDonald DG, Camilleri IG, Dunaway DJ, GrayHW, McCurrach GM, Bessent RG, MacLeod TIF, Robertson AG. The accuracy of head and neck carcinoma sentinel lymph node biopsy in the clinically N0 neck. Cancer.2001;91:2077-2083.

16 Kademani D. Oral cancer. Mayo Clinic proceedings. Mayo Clinic.Jul 2007;82(7):878-887.

17 Funk GF, Karnell LH, Robinson RA, Zhen WK, Trask DK, Hoffman HT. Presentation, treatment, and outcome of oral cavity cancer: a National Cancer Data Base report. Head neck. 2002 Feb;24(2):165-80.

18 Kraus FT, Perezmesa C. Verrucous carcinoma. Clinical and pathologic study of 105 cases involving oral cavity, larynx and genitalia. Cancer. Jan 1966;19(1):26-38.

19 Listl S, Jansen L, Stenzinger A, Freier K, Emrich K, et al.Survival of patients with oral cavity cancer in Germany. PLoS ONE.2013;8(1):e53415.

20 Anneroth G, Batsakis J, Luna M. Review of the literature and a recommended system of malignancy grading in oral squamous cell carcinomas. Scand J Dent Res.1987;95;229-249.

21 Edge SB, et al. The AJCC Cancer Staging Manual – Seventh Edition. American Joint Committee on Cancer 2010.

22 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed November 9, 2016. To view the most recent and complete version of the guideline, go online to www.NCCN.org. The NCCN Guidelines are a work in progress that may be refined as often as new significant data becomes available. The NCCN Guidelines are a statement of consensus of its authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult any NCCN Guidelines is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient’s care or treatment. The National Comprehensive Cancer Network makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way.

23 Jan JC, Hsu WH, Liu SA, Wong YK, Poon CK, Jiang RS, Jan JS, Chen IF. Prognostic factors in patients with buccal squamous cell carcinoma: 10-year experience. J Oral Maxillofac Surg. 2011 Feb;69(2):396-404.

24 Pradhan SA, Rajpal RM. Marginal mandibulectomy in the management of squamous cancer of the oral cavity. Indian J Cancer.1987;24;167-171.

25 Pentenero M, Gandolfo S, Carrozzo M. Importance of tumor thickness and depth of invasion in nodal involvement and prognosis of oral squamous cell carcinoma: a review of the literature. Head Neck. 2005 Dec;27(12):1080-91.

26 Maddox WA, Urist MM. Histopathological prognostic factors of certain primary oral cavity cancers. 1990 Dec;4(12):39-42; discussion 42,45-6.

27 Urist MM, O'Brien CJ, Soong SJ, Visscher DW, Maddox WA. Squamous cell carcinoma of the buccal mucosa: analysis of prognostic factors. Am J Surg. 1987 Oct;154(4):411-4.